Provider Demographics
NPI:1093763757
Name:MEMORIAL HOSPITAL OF UNION COUNTY
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL OF UNION COUNTY
Other - Org Name:MEMORIAL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAS
Authorized Official - Middle Name:A (CHIP)
Authorized Official - Last Name:HUBBS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:937-578-2288
Mailing Address - Street 1:500 LONDON AVE
Mailing Address - Street 2:ATTN: SPENCE FISHER
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5512
Mailing Address - Country:US
Mailing Address - Phone:937-644-6115
Mailing Address - Fax:937-578-2217
Practice Address - Street 1:120 COLEMAN'S CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9797
Practice Address - Country:US
Practice Address - Phone:937-578-4310
Practice Address - Fax:937-578-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care